Abstract LB208: A potent macrophage switching drug D-4559 reduces tumor GROWTH in a hepatocellular carcinoma mouse model
Authors: Naze G. Avci, Tony Wu, Susan E. Alters, Emily Zhang, Jinping Liu, Dong Huang, Natacha Le Moan, Jeffrey L. Cleland
Journal: Cancer Research (2023)

Abstract Tumor-associated macrophages (TAMs) play a role in cancer progression and are associated with Sorafenib resistance in hepatocellular carcinoma (HCC)1. D-4559 is a new potent macrophage switching nanomedicine technology that selectively inhibits VEGF receptor tyrosine kinases (VEGFR1, 2, 3) in TAMs leading to a functional reprogramming of TAMs toward a pro-inflammatory activated phenotype. Here, we evaluate the effect of D-4559 on the M1 and M2 polarization of TAMs and its anti-tumor efficacy in a murine HCC tumor model. In vivo efficacy of D-4559 was examined in the subcutaneous Hepa 1-6 liver tumor model in C57BL/6 mice. Animals (n=15/group) were treated with D-4559 (i.p., 200 mg/kg daily) and free drug Sorafenib (p.o., 40 mg/kg daily) as a positive control for 4 weeks. The treatment started when the mean tumor size reached approximately 100 mm3, then the animals were randomly allocated into study groups. The day of randomization and treatment was denoted as day 0. Tumor sizes were measured using a caliper for 27 days, M1/M2 macrophage polarization was examined by flow cytometry at day 16, and cytokine biomarkers were evaluated with MSD Cytokine Multiplex Assay at day 16 and 27.D-4559 significantly reduced Hepa 1-6 tumor growth (**p&amp;lt;0.01 vs. vehicle). D-4559 and Sorafenib efficacy were similar with 40% of mice with a tumor volume less than 500 mm3 after 27 days of treatment. At day 16, D-4559 significantly increased M1/M2 ratio by inducing M1 macrophage infiltration and reprogramming of TAMs into M1 macrophages compared to vehicle treatment groups (* p&amp;lt;0.05). In contrast, Sorafenib did not switch TAM polarization from M2 to M1 phenotype. Moreover, D-4559 significantly increased TNF-a and IL-8 cytokines in the tumor microenvironment at days 16 and 27, indicative of a M1 signature. Increased levels of TNF-a and IL-8 have also been correlated with better survival in HCC patients2,3. D-4559 significantly increased M1 infiltration, shifted TAM polarization from M2 to M1 phenotype and favored pro-inflammatory cytokines suggesting that D-4559 creates an immunopermissive tumor microenvironment leading to a reduction in tumor growth. This preclinical study supports the development of the potent macrophage switching drug D-4559 as a safe and effective agent that can be used systemically for the treatment of HCC or in combination therapies to improve anti-tumor immune response. References: 1. Wang et al, Journal of Biomedical Science (2022) 2. Hayashi, T., et al. BMC Cancer 17, 870 (2017) 3. Li, H., et al., Translational Cancer Research 8, 2 (2019) Citation Format: Naze G. Avci, Tony Wu, Susan E. Alters, Emily Zhang, Jinping Liu, Dong Huang, Natacha Le Moan, Jeffrey L. Cleland. A potent macrophage switching drug D-4559 reduces tumor GROWTH in a hepatocellular carcinoma mouse model [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr LB208.